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Health Information Management Program Policies. Revised November, 2014

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Health Information Management

Program Policies

Revised November, 2014

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CONTENTS

Introduction ... 1

A. Program Goals ... 2

C. Attendance Policy ... 2

D. Cheating ... 3

E. General Grading Policy ... 3

F. Student Responsibilities ... 3

G. Supervised Professional Practice (Clinical) ... 3

1. Placement ... 3

2. Costs ... 4

3. Professional Liability Insurance Requirements ... 4

4. Physical Exam Requirements ... 4

5. Dress Code ... 4

6. Schedule and Attendance ... 5

7. Supervision ... 5

8. Placement Functions ... 5

9. Students with Disabilities ... 5

10. Termination of Clinical Placement ... 5

11. Additional Rules ... 6

Appendices ... 7

AHIMA BS Entry Level Competencies 2011 ... 8

HIM Student Policies and Procedures Acknowledgement Form ... 12

Confidentiality Statement ... 13

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Introduction

The CUNY School of Professional Studies is pleased to welcome you to the Health Information

Management Program. We hope that you will find the coursework stimulating, challenging and rewarding. Employment opportunities for health information professionals are plentiful and of great variety. The faculty and staff are interested in your progress as a student and will assist you in your endeavor to acquire the education and skills necessary to practice in the health information management profession.

This handbook explains specific policies of the Health Information Management Program and is designed to serve as a supplement to the CUNY SPS Student Handbook. You are encouraged to familiarize yourself with the policies and procedures contained in this handbook.

Please sign the HIM Student Policies and Procedures Acknowledgement Form found on page 12 of this handbook. Submit the signed acknowledgment statement to your advisor by the end of your first semester at CUNY SPS.

Should you have any questions regarding these policies and procedures, please feel free to contact the Academic Director or your advisor.

Thank you for giving us the opportunity to provide you with the education needed to begin or enhance your career in health information management.

Ellen Shakespeare, MBA, RHIA, CHDA, FAHIMA Office phone (646) 344-7324

Cell phone: (646) 823-4781

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A. Program Goals

The CUNY School of Professional Studies (CUNY SPS), part of the Graduate School and University Center of the City University of New York, offers a B.S. degree in Health Information Management (HIM). This degree readies students to develop, implement, and manage health information and data systems for quality care, reimbursement, research, planning, and evaluation. A few of the most common job titles for health information professionals include Health Information Analyst, Information Auditor, Clinical Data Analyst, Privacy Officer, Compliance Specialist, Health Information Systems Trainer, and Information Systems Director. The program also prepares students for graduate education at the master’s level in health information management, health informatics, and healthcare administration.

Throughout the program, students will develop and demonstrate competency in the five primary knowledge, namely:

• Health Data Management

• Health Statistics, Biomedical Research, and Quality Management • Health Services Organization and Delivery

• Information Technology and Systems • Organization and Management

Our program goals at the City University of New York, School of Professional Studies Health Information Management program include the following:

1. Graduates will demonstrate the HIM entry-level competencies (AHIMA BS Entry Level Competencies included in the appendices).

2. Faculty will demonstrate current knowledge, skills, qualifications and professional development in the content areas they teach.

3. The HIM curriculum will include, at minimum, the required knowledge clusters with content and experiences to enable students to meet current entry-level competencies.

4. The HIM program will demonstrate responsiveness to the needs of the community(ies) of interest.

B. Accreditation

The HIM BS degree program is in Candidacy Status, pending accreditation review by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) www.cahiim.org.

C. Attendance Policy

Employers are very interested in a student’s attendance and study habits as it reflects how he/she will perform on the job. Students are expected to attend every Professional Practicum scheduled date on time. Additional information about attendance expectations is found in the Supervised Professional Practice (Clinical) section below.

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D. Cheating

Cheating may consist of plagiarism, copying from another student’s work, copying from notes, etc. Students caught cheating will be dismissed from the class, given a grade of “F,” and dismissed from the

program. Dishonesty, stealing and other violations of the student code of conduct will be handled on an individual basis. Students should familiarize themselves with the SPS Handbook and policies related to Academic Integrity. The SPS Handbook can be accessed at

http://sps.cuny.edu/filestore/8/3/9_dea303d5822ab91/839_1753cee9c9d90e9.pdf

E. General Grading Policy

A student’s grades are an indication to future employers of their ability to perform in the work setting. Often, employers establish minimum grades which must be met before an individual can be considered for certain areas of employment.

To help ensure that all HIM students are eligible for employment in the Health Information Management field, the program requires that students maintain a high level of academic and clinical performance. A minimum grade of “C” is required in all Health Information Management courses (those with a prefix of HIM). A student may not progress to the next course in the sequence without having made a “C” in the prerequisites course. Because of the sequential order of other courses, a student must realize the implications of delays caused by less than “C” level work. Failure to meet these standards will prevent normal progression through the program.

In addition, a student must maintain a grade point average of 2.0 to continue taking HIM courses. A student whose cumulative average falls below 2.0 at the end of any semester while taking HIM courses will be allowed one semester in which to raise his/her cumulative average to 2.0. The student may enroll in no further HIM courses until a cumulative grade point average of 2.0 is reached. The student may not be able to enroll in the Professional Practicum courses unless a grade of “C” or better is maintained in the HIM and related courses.

F. Student Responsibilities

Students must:

• Be prepared with required text(s) and supplies • Complete all coursework on time

• Actively participate as required in Blackboard

G. Supervised Professional Practice (Clinical)

1. Placement

a. Clinical sites will be selected from hospitals (or other workplaces) within a reasonable commuting distance (as determined by the HIM faculty) from CUNY SPS or the student’s home.

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b. A student currently or previously employed in a health care facility (or other HIM-related employment) will generally not be assigned to that organization for the clinical experience. To do so could create difficulty in assessing student performance.

c. Students are required to make contact with Career Services during the semester prior to the semester in which the placement will occur.

d. Students will be advised when and how to contact the assigned Site Coordinator for instructions on reporting to work.

2. Costs

a. Student transportation and all costs involved in the performance of clinical duties shall be assumed by the student. Student car pools are the responsibility of the individual student and are not the responsibility of the Program or the College.

b. No reimbursement or benefits will be awarded to the student for any efforts made in the course of the clinical affiliation.

3. Professional Liability Insurance Requirements

a. All students participating in fieldwork and/or a clinical experience are required to purchase Student Professional Liability Insurance.

b. Students may purchase a policy from an insurance company of their choice. However, SPS recommends Healthcare Providers Service Organization - http://www.hpso.com/professional-liability-insurance/student-coverage-description.jsp.

c. When students complete the application for insurance they must select their area of study. HIM students will select either Medical Records Administrator or Medical Records

Technician/Technologist.

d. Once a student has purchased a policy they must submit a copy to Academic Director of their program.

4. Physical Exam Requirements

All students participating in fieldwork and/or a clinical experience are required to submit a physical examination form completed by licensed physician. This form is available at the end of this handbook and will be made available to Academic Directors for distribution to faculty/students. 5. Dress Code

a. Student attire at the clinical site shall consist of clothing that is neat and attractive and allows the student to present him/herself in a professional manner. In some instances, it will be necessary to follow the dress code of the clinical site facility.

b. Female students are expected to wear clothing with a skirt of satisfactory length. Dress slacks or pantsuits are acceptable.

c. Male students are expected to dress in a likewise professional manner which should include tailored slacks and dress shirt. It is preferred that a male student wear a tie and that it be coordinated with his attire.

d. Blue jeans, shorts, halter tops, tee shirts with graphic/written patterns or other attire deemed to be inappropriate by the HIM faculty or the clinical site shall not be allowed.

e. Shoes should be comfortable, well cared for and should be appropriate for professional attire. No tennis/athletic shoes, boots, clog-type shoes shall be allowed. Of particular note is the attention that should be paid to safety, and for this reason, the wearing of heels of an excessively high nature is discouraged. Some clinical sites forbid open-toed shoes.

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6. Schedule and Attendance

a. Student is expected to report to the affiliation site at 9:00 a.m. on the first morning unless otherwise previously arranged with the Site Coordinator.

b. Student will be working a minimum of 8 hours per day on each scheduled clinical day, unless other hours have been prearranged.

c. The Site Coordinator can schedule evening, night or weekend shifts in student’s schedule if it is felt that it would be helpful to the student’s learning experience.

d. Lateness: It is important that the student reports to clinical on time. In the instance of anticipated lateness, student must report the anticipated lateness to assigned preceptor prior to scheduled clinical date and time. All lost time must be made up.

e. Absence: Student should make every effort to attend scheduled Clinicals. Anticipated

absences must be reported to the preceptor prior to scheduled clinical date and time. All lost time must be made up.

f. Should student become ill while on duty, notify the Site Coordinator. Arrangements will be made for medical attention as appropriate with existing departmental procedures. Student is responsible for the costs incurred in this treatment.

7. Supervision

a. While at the affiliation site, students are directly responsible to the Site Coordinator. Student is asked to abide by the policies of the clinical site concerning breaks, parking, personal

telephone calls, etc., as well as all facility policies and regulations. It is the student’s responsibility to determine what the rules and regulations are.

b. If any problems arise, they should be brought to the attention of the assigned Site Coordinator. However, the Faculty Clinical Coordinator is available by phone should the student need consultation at any time.

8. Placement Functions

a. Student will be scheduled to be involved with Health Information Management (HIM) functions. During this time, student will collect information for project assignments. Project completion is not to be done during affiliation working hours, unless permission is granted by Site Coordinator member (i.e., report writing).

b. Attending meetings is an excellent opportunity for exposure to committee/project activities and to observe group dynamics. Student is encouraged to communicate with his/her Site

Coordinator about upcoming meetings of interest. 9. Students with Disabilities

ADA - Americans with Disabilities Act. Student must notify clinical site of any disability that needs special consideration.

10. Termination of Clinical Placement

Unsatisfactory progress or conduct could result in an academic or disciplinary termination from the clinical placement. If there is evidence that termination may occur, the Faculty Clinical Coordinator will be contacted by the Site Coordinator. A meeting between the student and the Site Coordinator will be scheduled to discuss the circumstances. A meeting of the Site Coordinator and Faculty Clinical Coordinator will follow. At this time, a decision will be made as to whether the student will continue in the placement.

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a. APPEAL - Each student will have the right to appeal an academic or disciplinary termination from the clinical placement site.

i. The student shall appeal within five business days from date of termination to the Academic Program Director.

ii. Academic Program Director shall inform the student of the outcome of the appeal in writing within seven business days.

iii. If the student wishes to appeal further, he/she shall file a written appeal within five business days to the Associate Dean of Academic Affairs.

iv. The Associate Dean of Academic Affairs shall meet with the student. The Associate Dean of Academic Affairs will issue a written decision within seven business days.

v. If the student is still not satisfied with the decision, she/he may file a written appeal to the Dean of the School of Professional Studies.

vi. The Dean’s decision will be final.

b. If a student is removed from a clinical placement site, that entire clinical experience will have to be repeated.

11. Additional Rules

a. Students who will drive to their placement are to park only in the areas designated for student use by the clinical site. All costs incurred as a result of parking are the responsibility of the student.

b. Cell phones may only be used during break periods. If the facility prohibits the use of cell phones in the building, students must adhere to this rule. Breach of these rules will result in disciplinary action.

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AHIMA BS Entry Level Competencies 2011 I. Domain: Health Data Management

I.A. Subdomain: Health Data Structure, Content, and Standards

1. Manage health data (such as data elements, data sets, and databases).

2. Ensure that documentation in the health record supports the diagnosis and reflects the patient’s progress, clinical findings, and discharge status.

I.B. Subdomain: Healthcare Information Requirements and Standards 1. Develop organization-wide health record documentation guidelines. 2. Maintain organizational compliance with regulations and standards.

3. Ensure organizational survey readiness for accreditation, licensing and/or certification processes. 4. Design and implement clinical documentation initiatives.

I.C. Subdomain: Clinical Classification Systems

1. Select electronic applications for clinical classification and coding.

2. Implement and manage applications and processes for clinical classification and coding. 3. Maintain processes, policies, and procedures to ensure the accuracy of coded data. I.D. Subdomain: Reimbursement Methodologies

1. Manage the use of clinical data required in prospective payment systems (PPS) in healthcare delivery.

2. Manage the use of clinical data required in other reimbursement systems in healthcare delivery. 3. Participate in selection and development of applications and processes for chargemaster and claims management.

4. Implement and manage processes for compliance and reporting. 5. Participate in revenue cycle management.

II. Domain: Health Statistics, Biomedical Research, and Quality Management II.A. Subdomain: Healthcare Statistics and Research

1. Analyze and present data for quality management, utilization management, risk management, and other patient care related studies.

2. Utilize statistical software.

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II.B. Subdomain: Quality Management and Performance Improvement

1. Provide support for facility-wide quality management and performance improvement programs. 2. Analyze clinical data to identify trends that demonstrate quality, safety, and effectiveness of healthcare.

3. Apply Quality Management tools.

III. Domain: Health Services Organization and Delivery III.A. Subdomain: Healthcare Delivery Systems

1. Evaluate and implement national health information initiatives in the healthcare delivery system for application to information systems policies and procedures.

2. Interpret, communicate, and apply current laws, accreditation, licensure and certification standards related to health information initiatives at the national, state, local, and facility levels. 3. Analyze and respond to the information needs of internal and external customers throughout the continuum of healthcare services.

4. Revise policies and procedures to comply with the changing health information regulations. 5. Translate and interpret health information for consumers and their caregivers.

III.B. Subdomain: Healthcare Privacy, Confidentiality, Legal, and Ethical Issues

1. Coordinate the implementation of legal and regulatory requirements related to the health information infrastructure.

2. Manage access and disclosure of personal health information.

3. Develop and implement organization-wide confidentiality policies and procedures. 4. Develop and implement privacy training programs.

5. Assist in the development of security training. 6. Resolve privacy issues/problems.

7. Apply and promote ethical standards of practice. 8. Define and maintain elements of the legal health record. 9. Establish and maintain e-Discovery guidelines.

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IV. Information Technology and Systems

IV.A. Subdomain: Information and Communication Technologies

1. Implement and manage use of technology, including hardware and software to ensure data collection, storage, analysis, and reporting of information.

2. Contribute to the development of networks, including intranet and Internet applications to facilitate the electronic health record (EHR), personal health record (PHR), public health, and other administrative applications.

3. Interpret the use of standards to achieve interoperability of healthcare information systems. IV.B. Subdomain: Information Systems

1. Apply knowledge of database architecture and design (such as data dictionary, data modeling, data warehousing) to meet organizational needs.

2. Monitor use of clinical vocabularies and terminologies used in the organization’s health information systems.

3. Manage clinical indices/databases/registries.

4. Apply appropriate electronic or imaging technology for data/record storage.

5. Apply knowledge of database querying and data mining techniques to facilitate information retrieval.

6. Implement and manage knowledge-based applications to meet end-user information requirements.

7. Design and generate administrative reports using appropriate software. 8. Apply appropriate electronic or imaging technology for data/record storage. 9. Participate in system selection processes (RFI and RFP).

10. Evaluate and recommend clinical, administrative, and specialty service applications (RFP vender selection, electronic record, clinical coding).

11. Apply appropriate systems to life cycle concepts, including systems analysis, design,

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IV.C. Subdomain: Data Security

1. Protect electronic health information through confidentiality and security measures. 2. Protect data integrity and validity using software or hardware technology.

3. Implement and monitor department and organizational data and information system security policies.

4. Recommend elements that must be included in the design of audit trails and data quality monitoring programs.

5. Recommend elements that should be included in the design and implementation of risk assessment, contingency planning, and data recovery procedures.

V. Organization and Management

V.A. Subdomain: Human Resources Management

1. Manage human resources to facilitate staff recruitment, retention, and supervision. 2. Ensure compliance with employment laws.

3. Develop and implement staff orientation and training programs. 4. Develop productivity standards for health information functions.

5. Monitor staffing levels and productivity, and provide feedback to staff regarding performance. 6. Benchmark staff performance data incorporating labor analytics.

7. Develop, motivate, and support work teams. 8. Analyze and report on budget variances. 9. Evaluate and manage contracts.

10. Apply principles of ergonomics to work areas.

V.B. Subdomain: Strategic Planning and Organizational Development

1. Apply general principles of management in the administration of health information services. 2. Assign projects and tasks to appropriate staff.

3. Demonstrate leadership skills.

4. Apply project management techniques to ensure efficient workflow and appropriate outcomes. 5. Facilitate project management by integrating work efforts, as well as planning and executing project tasks and activities.

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HIM Student Policies and Procedures Acknowledgement Form By signing below, I acknowledge and agree to the following:

1. I have received and reviewed the 2013 CUNY School of Professional Studies (CUNY SPS) Health Information Management Student Handbook.

2. I will abide by the rules and regulations set forth in the HIM Student Handbook.

3. I understand that information course schedules, registration, withdrawal and tuition deadlines, and other pertinent policies and deadlines are available via the CUNY SPS website (http://sps.cuny.edu/).

4. I understand that I am required to purchase professional liability insurance prior to beginning my practicum. 5. I understand that I am required to obtain a physical and proof of immunity before I may be placed at any facility

for a practicum (form located at the end of the HIM Student Handbook).

6. I understand that I am required to sign the Confidentiality Agreement (located on page 13 of the HIM Student Handbook) prior to beginning my practicum.

Name:

Home Address:

Telephone Number:

E-mail address:

Student ID#:

Date:

Signature:

NOTE: This form is a program requirement and will be maintained in your school records. Not submitting this form may result in the inability to register for the professional practice experience classes. Please mail this completed form to:

Ellen Shakespeare, MBA, RHIA, CHDA, FAHIMA Academic Director, Health Information Management City University of New York

School of Professional Studies 119 West 31st Street

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CUNY School of Professional Studies Health Information Management Program

Confidentiality Statement

I understand and agree that in the pursuance of my work as a student in the HIM program of CUNY School of Professional Studies I must hold all health information with regard to specific patients, healthcare workers and healthcare facilities in confidence. I understand that I will be privy to such information both in the classroom, as well as at clinical affiliation sites. I also understand that all health information regarding specific patients, healthcare workers and healthcare facilities, whether it is obtained in written, verbal, or any other format, is considered a privileged communication between the patient and the patient’s physician, and as such, may not be released without the patient’s written consent.

I further understand that any violation of the confidentiality of health information may result in dismissal from the HIM program, as well as possible legal action against me.

Student Signature: __________________________________ Date: ____________ Student Printed Name: _________________________________

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CUNY School of Professional Studies

Student Health Form for Fieldwork/Clinical Placements

Student’s Name __________________________________________________________________________ Sex M F

Last First

Address _____________________________________________________________________________________________

Street City State Zip Code

PHYSICAL EXAMINATION

(To be completed by a licensed Physician)

HEIGHT___________ WEIGHT ___________ VISION O.D. ___________ CORR ____________ O.S. ____________ T.B. SKIN TEST TYPE _______________________ DATE ______________ RESULT _______________________________ B.P.______/_____ mm/Hg Pulse ______________/min TETANUS-DIPHTHERIA DATE __________________________ TITERS FOR: Varicella Date _________________ Mumps Date _________________ Rubella Date _________________ Hepatitis B Profile Date ______________ Urine Toxicology Screen _______________________________________________

Normal Abnormal Remarks – Describe Abnormalities Only

Head and Neck Nose and Sinuses Mouth and Throat Gums and Teeth Eyes

Ears, Hearing Chest, Breasts, Lungs Heart

Vascular System Lymphatic System Abdomen and Viscera Hernia

Anus and Rectum Genito-Urinary System Endocrine System

Spine and Musculoskeletal

Skin-Identifying Marks, Scars, Tattoos Neurologic

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This examination includes physical and laboratory studies to ensure that the above student has no health impairments which could pose a potential harm to patients/clients or which might interfere with the student’s performance of his or her clinical/fieldwork duties. Physician Name __________________________________________________________ Date ________________________ Physician’s Signature __________________________________________________ License # _________________________ Address _____________________________________________________________ Telephone ________________________ DATE OF EXAMINATION ________________________________

The CUNY School of Professional Studies does not discriminate on the basis of sex, age, color, veteran’s status, race, religion, national origin, sexual orientation or handicap.

References

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